The great Greek physician and teacher Hippocrates (460 BC-370 BC) described several kinds of cancer, referring to them with the Greek word "carcinos", meaning crab or crayfish. This name comes from the appearance of the cut surface of a solid malignant tumor, with the "veins stretched out on all sides as the animal the crab has its feet, whence it derives its name."

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Tag Archives: William Shakespeare

Have I given fire and rifted Jove’s stout oak
With his own bolt; the strong-based promontory
Have I made shake and by the spurs pluck’d up
The pine and cedar: graves at my command
Have waked their sleepers, oped, and let ‘em forth
By my so potent art. But this rough magic
I here abjure

Prospero, The Tempest, Wm. Shakespeare

Two weeks ago today, we lost our big male deerhound Magic. It should not have been any surprise—he had been diagnosed with cardiomyopathy in August and from the looks of his echocardiogram August 8th, his days were numbered. He was with us for over ten years, a long life for a giant hound. But the finality of death is always a surprise, isn’t it?

Can dogs perceive tragedy in their lives? Do they grieve as we do? If so, Magic had grief aplenty. Acquired as a four month old puppy with his half-sister Angelina, he was fine until at six months, he fractured a metatarsal bone taking a corner too fast, and after surgery to pin the shattered bone he spent six weeks in a cast. He recovered just fine, well enough to finish his championship at 18 months without a trace of a limp to suggest his prior injury. From the time he was a puppy, we called him The Dog Who Never Did Anything Wrong. He never got sick, never barked, never growled, and never EVER had an accident in the house. Following the example of our older male Izzy, he was a friend to all—humans, dogs and cats. Well maybe once he chased a horse, but after the embarrassment of being chastised, he never did it again. He was a homebody, afraid of fireworks and thunder and lightning, but as long as he had his family about him, he bore no complaint. When his sister and constant companion Angelina passed, he clearly had a period of sadness, but bounced back quickly. But when we lost Izzy and in rapid succession the little dog Jack to old age, Magic lay down on the carpet in the family room between the coffee table and the chairs, head between forelegs, and there he stayed. He ate his meals, and went out twice a day to do his business (“whether he needed to or not!” we joked). But the exuberance and sense of humor that characterizes the deerhound personality was gone.

When we sold our home in San Diego in October, and decided to move to New Mexico, Magic was the dog we worried about the most. Given his heart condition, we weren’t sure that he could make the transition to altitude and cold weather. We worried and fretted and even considered putting him to sleep, but in the end, since he wasn’t in any pain, we loaded him, the two girl deerhounds and the little rescue Yoda into the van and off we went. Our biggest fear was that we would have to find a veterinarian somewhere along Interstate 40 to do what we hadn’t been able to bring ourselves to do before we left. But the big dog surprised us. Here in Santa Fe, he seemed to take a new lease on life. Suddenly he was interested in his surroundings—he ran, he played, and he discovered where the bunnies were hiding in the culvert. He patrolled the fence line at sunset, watching for coyotes. He assumed the role of pack leader for the first time in his life. His two female consorts adored him, and he was The Man. And, like a family member of any patient diagnosed with a terminal illness, I began to have magical thinking: first, let’s see if he makes his tenth birthday! He did. Then, let’s see if he makes Thanksgiving, when the kids come home! He did. And then, jeepers, maybe he’ll see Christmas, and even another New Years! He did. So then I began thinking about his eleventh birthday, next October. As I said, death is always a surprise.

As we get older, each loss hits harder. I’ve done a lot of thinking about this these last two weeks. When we are children, the family dog seems to live forever. He’s there when we start kindergarten, then junior high, then high school. He comforts us when we’re sad. Our lives, and his life, while not equivalent, are at least proportionate. But as we age, the lifespans of our pets seem to shrink. Now that I am 61, Magic’s life seems to mine a mere blink of the eye. He was there, beside my bed, every night for ten years. And now he is gone, and I’ll never again curse under my breath as I trip over him in the dark, and my life is much the worse for that.

Yesterday I had the unique experience of watching a production of William Shakespeare’s The Tempest, acted, with musical accompaniment, entirely by a group of fifth graders. Friends of mine from Los Angeles, himself a teacher at the Hobart Boulevard public elementary school, had invited me to this year’s presentation by the Hobart Shakespeareans. As many of you know, punctuality has never been one of my virtues, and the 105 mile drive, coupled with the infamous LA traffic, had me sweating before I even took my seat. But once I had clamored over Kurt’s knees and nearly fallen into Heather’s lap, I settled in for nearly three hours of pure magic, and not just the magic of Propero, the magician of the Tempest.

Begun years ago by their remarkable teacher Rafe Esquith, the fifth grade Hobart Shakespeareans of Room 56 are a group of underserved, underfunded children of largely Korean and Mexican first generation parents. Many do not speak English when they arrive at school, many are on federally funded school lunch programs. But by the fifth grade, those children lucky enough to be in Room 56 have studied the works of Will to the extent that they produce, in full Elizabethan English tempered with the sounds of rock and roll, reggae and Beethoven, a Shakespearean masterpiece a year. When the lights went down yesterday, at 11 am, I was transported, and overwhelmed–and instantly moved to tears.

As an English major in college, the teaching of the humanities, and English in particular, has always been near and dear to my heart. I believe that by studying great works of literature, and Shakespeare in particular, one can experience the breadth and scope of human emotion—joy, sorrow, aspiration, suffering, love, longing, mystery and hope—in short, most of the qualities necessary to become a good doctor. Sadly, college premedical requirements do not include more than a cursory English class or two, mainly to make sure that a student can string together a few words to write a sentence. The world of science and medicine has become infinitely more complicated in the last several decades—there is so much to learn about biochemistry that taking on “extras” like an advanced literature class, or an art class or a philosophy class becomes a burden, instead of a pleasure. While many medical schools encourage non-science majors to apply, the truth of the matter is that humanities majors are significantly disadvantaged when it comes to taking the MCATs and showing publications on their resumes.

The Hobart Shakespeareans come to school at 7 am, and stay until 5 pm. They learn math, and science, and history and geography and government but lunchtime is reserved for rock and roll guitar lessons. They wear T-shirts with the face of William Shakespeare and the caption, Will Power. Judging from the college banners placed around the perimeter of room 56, and the names below them, ultimately they attend Yale, and Harvard, and UCLA and Stanford, as often if not more than their more privileged peers. And many of them will become doctors. They live by the motto: “Be Nice. Work Hard.”

Since I’ve been writing this blog, quite a few people have said to me, “You should write a book!” Let me be clear in my self-assessment—first of all, I don’t have the attention span these days to write a book. A novel has a plot, well developed characters, a beginning, a middle and an ending. I’m not sure but I have a feeling that most good fiction writers have a clear idea of the story they want to tell before they start writing. “But wait”, you say. “You should write a nonfictional account of your work—a true cancer doctor story.” This territory has been covered, most famously by Jerome Groopman who wrote The Measure of our Days, which became the inspiration for the television show Gideon’s Crossing. How about a history of cancer itself? Again, already taken in the most definitive way imaginable—I give you The Emperor of All Maladies by Siddhartha Mukherjee. Of course, the books that scare me the most are the ones by cancer doctors who actually GET cancer and there are several of those out there too—consider I Signed as a Doctor by Laura Liberman whose title refers to the fact that when she had to sign consent for her own cancer treatment, she signed on the wrong line—the doctor’s space. Call me superstitious but I don’t want to tempt fate.

Why do so many physicians feel compelled to write? Ethan Canin (Carry Me Across the Water, America America) graduated from Harvard Medical School and actually practiced medicine for several years until the publication of his third novel allowed him to write full time. He now teaches on the faculty of the Iowa Writer’s Workshop, and has been quoted as saying that “everyone has an expressive urge, but it’s particularly pronounced among those who practice medicine.” He goes on to say, “It’s like being a soldier—you’ve seen great and terrible things.” I don’t think being a doctor is like being a soldier because our lives are not typically in danger (although ER doctors in inner city hospitals might argue that point!) I think of it more as a compulsion to “bear witness,” Ancient Mariner-style. We spend much of our days writing down histories, and many of those histories give a small glimpse into the essence of what makes us human, and what gives us courage and hope. There is nothing like a serious illness to separate the wheat from the chaff of life.

I was an English major in college, and though I will never be a John Keats or a William Carlos Williams-two of my physician-poet idols, I will never regret the time I spent reading their works, or the great works of Shakespeare and Milton and Hemingway and all the others. I may have been a bit behind in the basic sciences but that path of study gave me the tools to actually listen to my patients, to interpret what they are saying, and in turn, to be able to write down their stories. I don’t have a major new novel swirling around in the back of my head, so for now I’ll just continue with these little vignettes. And I would really appreciate it if my friends and readers would send me some of their own stories. Who knows—there might be a blockbuster movie in there somewhere. If not, there’s always law school!

About

In 2012, I realized that my thirty plus years of practice as a radiation oncologist had provided me with an abundance of stories–happy, sad, compelling and inspiring–and that these stories needed to be told. Along the way, stories from my “other life” as a mother of three, a daughter, an animal lover, and an occasional world traveler crept in. I hope you enjoy my stories as much as I enjoy telling them.